Virginia Medicaid rate for CPT 11042
Virginia Medicaid pays $114.87 for CPT 11042 in its October 2026 fee-for-service schedule: the 11th-highest of 45 state Medicaid programs, at 117% of the $98.39 median.
- Non-facility rate
- $114.87
- Rank
- 11 of 45
- vs. state median
- 117%
- vs. VA Medicare
- 76-89%
What Virginia Medicaid publishes for 11042
11th-highest of 45 · 117% of median
- Schedule
- October 2026
- In effect since
- Jul 1, 2026
- Prior authorization
- Not required
1 rate type
- Under 21 and 1 more
- Facility $48.32
Unmodified non-facility fee-for-service rate from the state's published file. Managed-care contracts, supplemental payments, and claim-specific adjustments can change what is paid. DMAS Procedure Fee Files
11042 in neighboring states
Each state's comparable non-facility rate for 11042 in its current schedule.
| State | Rate | vs. Virginia |
|---|---|---|
| Kentucky | $48.18 | -58% |
| Maryland | $92.58 | -19% |
| North Carolina | $53.26 | -54% |
| West Virginia | $88.82 | -23% |
11042 in every state
Map and ranking of every state program that prices 11042.
Compare 11042 across states11042 under Medicare
Medicare's 2026 non-facility payment for 11042 in Virginia is $129.70 to $151.86 across its 2 payment localities; Virginia Medicaid's rate is 76-89% of that. The national amount before geographic adjustment is $132.602.
See 11042 Medicare ratesSee Virginia's full schedule: all 8,748 codes, every published period, and commercial payer rates for 11042.
Book a 15-min Medicaid walkthrough